Hemiballism, a rare complication of coil embilization

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Cerebral aneurysm coiling is a common endovascular procedure.
• Thromboembolism is a known complication, typically causing transient ischemic attacks or strokes.
• Neurological deficits like weakness and aphasia are commonly observed.

Observation:

• A 69-year-old female underwent coil embolization for a posterior communicating artery aneurysm.
• Post-procedure, she developed global aphasia and right hemiparesis due to multiple small infarctions in the left middle cerebral artery territory.
• While initial deficits resolved, hemiballism emerged subsequently without other identifiable causes.

Findings:

• This case presents a rare delayed neurological complication of cerebral aneurysm coil embolization.
• Hemiballism, a hyperkinetic movement disorder, occurred after initial thromboembolic events.
• Treatment with clonazepam and antiepileptics led to the resolution of hemiballism.

Implications:

• This case underscores the potential for unusual and delayed neurological sequelae following endovascular aneurysm treatment.
• It highlights the importance of considering thromboembolism as a cause of diverse neurological presentations, including hemiballism.
• Further research may be needed to understand the mechanisms and risk factors for such rare complications.